儿童胰腺损伤的MSCT诊断

MSCT Features of Pancreatic Injury in Children

目的探讨MSCT在儿童胰腺损伤的诊断价值。方法回顾性分析经临床、实验室检查及CT明确诊断和手术探查(4例)及临床随访证实的18例闭合性腹部外伤致胰腺损伤患儿的CT表现并按损伤程度进行分级。结果胰腺损伤CT表现的直接征象有:胰腺肿大(7例),胰腺实质裂伤(5例),实质裂伤伴胰管断裂(2例),胰腺内出血/积液(5例)。间接征象有:胰周被膜和肾周筋膜增厚(6例),小网膜囊、胰周及肾旁间隙出血/积液(10例),胰周及腹膜后炎性反应(3例),胰周假性囊肿(10例)。合并肝、肾及十二指肠损伤各1例,脾损伤2例。Ⅰ级7例,Ⅱ级6例,Ⅲ级3例,Ⅳ级2例。结论结合临床及外伤病史,MSCT检查对儿童胰腺损伤能作出正确诊断并可作为首选方法。

Objective TYo study the value of MSCT examination in diagnosis of pancreatic injury. Methods MSCT features of 18 children with pancreatic injury caused by closed abdominal trauma were analyzed retrospectively. 4 patients with pancreatic injury had been confirmed by operation. Pancreatic injury were graded according to injury grading criteria. Results The direct signs of pancreatic injury included pancreas enlargement in 7 cases; pancreatic rupture in 5 cases; pancreatic and pancreatic duct rupture in 2 cases; pancreatic hematoma or fluid in 5 cases）. The indirect signs included thickening of pancreatic and renal facial in 6 cases, fluid collected in peri-pancreas small bursa omentalis and peri-renal space in 10 cases; peri-panereatic and retroperitoneal infection in 3 cases ; peri-pancreatic pseudocyst in 10 cases. Pancre- atic injury were found complicated with liver contusion in 1 case, kidney injury in 1 case, duodenumor injury in 1 case and spleen injury in 2cases. The number of I , Ⅱ , Ⅲ, Ⅳgrade injury were 7,6,3, and 2 cases. Conclusion MSCT should be choosed as the first examination in the diagnosis of pancreatic injury in children.